Investigating unmet need for healthcare using the European Health Interview Survey: a cross-sectional survey study of Luxembourg

ObjectivesWe investigate the prevalence of unmet need arising from wait times, distance/transportation and financial affordability using the European Health Interview Survey. We explore associations between individual characteristics and the probability of reporting unmet need.DesignCross-sectional survey conducted between February and December 2014.Setting and participants4004 members of the resident population in private households registered with the health insurance fund in Luxembourg aged 15 years and over.Outcome measuresSix binary variables that measured unmet need arising from wait time, distance/transportation and affordability of medical, dental and mental healthcare and prescribed medicines among those who reported a need for care.ResultsThe most common barrier to access arose from wait times (32%) and the least common from distance/transportation (4%). Dental care (12%) was most often reported as unaffordable, followed by prescribed medicines (6%), medical (5%) and mental health (5%) care. Respondents who reported bad/very bad health were associated with a higher risk of unmet need compared with those with good/very good health (wait: OR 2.41, 95% CI 1.53 to 3.80, distance/transportation: OR 7.12, 95% CI 2.91 to 17.44, afford medical care: OR 5.35, 95% CI 2.39 to 11.95, afford dental care: OR 3.26, 95% CI 1.86 to 5.71, afford prescribed medicines: OR 2.22, 95% CI 1.04 to 4.71, afford mental healthcare: OR 3.58, 95% CI 1.25 to 10.30). Income between the fourth and fifth quintiles was associated with a lower risk of unmet need for dental care (OR 0.29, 95% CI 0.16 to 0.53), prescribed medicines (OR 0.38, 95% CI 0.17 to 0.82) and mental healthcare (OR 0.17, 95% CI 0.05 to 0.61) compared with income between the first and second quintiles.ConclusionsRecent and planned reforms to address waiting times and financial barriers to accessing healthcare may help to address unmet need. In addition, policy-makers should consider additional policies targeted at high-risk groups with poor health and low incomes.

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Implementation of the European health interview survey into the National FinSote survey in Finland

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.186 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Parikka ◽

T Koskela ◽

J Ikonen ◽

H Kilpeläinen ◽

H Tolonen

Keyword(s):

Health Care ◽

Social Background ◽

Well Being ◽

Health Determinants ◽

Cross Sectional ◽

Health Interview Survey ◽

Health Interview ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Abstract Background This methodological paper describes the integration of the European Health Interview Survey wave 3 (EHIS 3) into the National FinSote Survey (FinSote2019/EHIS). Finnish Institute for Health and Welfare (THL) conducted the survey in Finland. Methods FinSote 2019/EHIS was conducted as a cross-sectional health, welfare and services survey. A simple random sampling was used to recruit 15 000 individuals aged 15 years and older. Data collection was carried out by self-administered questionnaire that was available in web and paper form. To minimize the respondent burden socio-demographic background variables were obtained from administrative registers. In Finland, EHIS wave 3 was conducted as a part of the National FinSote survey. The questionnaire included both EHIS 3 modules on health status, health care, health determinants (excluding derogation variables), social background variables and additional national questions. In data processing, two datasets were formed: national dataset for sustaining time series as well as monitoring nationally relevant topics and EHIS dataset including the quality and validation rules specified by Eurostat. Results In total, 6,251 questionnaires were completed. The response rate was 44 % in EHIS data (aged 15+) and 45 % in national FinSote data (aged 20+). The representativeness of the results was increased by applying weighting procedures. The sample size was just large enough to achieve the precision requirements determined by Eurostat. Access to micro data of the EHIS 3 will be provided by Eurostat and to the FinSote 2019/EHIS by THL. Conclusions Integrating EHIS wave 3 into an existing national monitoring system was challenging in Finland. The harmonization might lead to interruptions of existing national time trends. Inclusion of some national well-being and social care variables might be irrelevant to respondent aged 15-19 years. Key messages Conducting EHIS as a part of National FinSote survey in Finland was cost-effective but challenging. Cultural differences in regards to living conditions in younger respondents and health care system made it challenging to integrate EHIS into national survey.

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Population level of unmet need for mental healthcare in Europe

The British Journal of Psychiatry ◽

10.1192/bjp.bp.106.022004 ◽

2007 ◽

Vol 190 (4) ◽

pp. 299-306 ◽

Cited By ~ 145

Author(s):

Jordi Alonso ◽

Miquel Codony ◽

Viviane Kovess ◽

Matthias C. Angermeyer ◽

Steven J. Katz ◽

...

Keyword(s):

Mental Disorders ◽

Health Services ◽

Adult Population ◽

Unmet Need ◽

Mental Healthcare ◽

Composite International Diagnostic Interview ◽

Population Level ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Use Of Services

BackgroundThe high prevalence of mental disorders has fuelled controversy about the need for mental health services.AimsTo estimate unmet need for mental healthcare at the population level in Europe.MethodAs part of the European Study of Epidemiology of Mental Disorders (ESEMeD) project, a cross-sectional survey was conducted of representative samples of the adult general population of Belgium, France, Germany, Italy, The Netherlands and Spain (n=8796). Mental disorders were assessed with the Composite International Diagnostic Interview 3.0. Individuals with a 12-month mental disorder that was disabling or that had led to use of services in the previous 12 months were considered in need of care.ResultsAbout six per cent of the sample was defined as being in need of mental healthcare. Nearly half (48%) of these participants reported no formal healthcare use. In contrast, only 8% of the people with diabetes had reported no use of services for their physical condition. In total, 3.1% of the adult population had an unmet need for mental healthcare. About 13% of visits to formal health services were made by individuals without any mental morbidity.ConclusionsThere is a high unmet need for mental care in Europe, which may not be eliminated simply by reallocating existing healthcare resources.

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Hungarian diet and nutritional status survey – The OTAP2009 study I. Nutritional status of the Hungarian population

Orvosi Hetilap ◽

10.1556/oh.2012.29375 ◽

2012 ◽

Vol 153 (26) ◽

pp. 1023-1030 ◽

Cited By ~ 13

Author(s):

Éva Martos ◽

Viktória Anna Kovács ◽

Márta Bakacs ◽

Csilla Kaposvári ◽

Andrea Lugasi

Keyword(s):

Nutritional Status ◽

Abdominal Obesity ◽

Public Health Problem ◽

Participation Rate ◽

Population Level ◽

Prevalence Of Obesity ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey ◽

And Gender

Obesity is a leading public health problem, but representative data on measured prevalence among Hungarian adults has been missing since the late eighties. Aim and method: Joining in European Health Interview Survey the aim of the OTAP2009 study was to provide data representative by age and gender on the prevalence of obesity and abdominal obesity among Hungarian adults based on their measured anthropometric data. Results: Participation rate was 35% (n = 1165). Data shows that nearly two-thirds of adults are overweight or obese. 26.2% of men and 30.4% of women are obese. Prevalence of morbid obesity is 3.1% and 2.6% in men and women, respectively. Abdominal obesity is more prevalent among women than men (51.0% vs. 33.2%), and rate is increasing parallel with age in both gender. In elderly, 55% of men and almost 80% of women are abdominally obese. Conclusions: Besides interventions of population level for tackling obesity, individual preventive measures are indispensable. Orv. Hetil., 2012, 153, 1023–1030.

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National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2017.73.6314 ◽

2017 ◽

Vol 35 (34) ◽

pp. 3800-3806 ◽

Cited By ~ 112

Author(s):

Christopher P. Childers ◽

Kimberly K. Childers ◽

Melinda Maggard-Gibbons ◽

James Macinko

Keyword(s):

Ovarian Cancer ◽

Genetic Testing ◽

Unmet Need ◽

Cancer Control ◽

The United States ◽

Eligibility Criteria ◽

Cross Sectional ◽

Age Of Diagnosis ◽

History Of ◽

Interview Survey

Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.

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Perspectives from Dentists, Dental Assistants, Students, and Patients on Dental Care Adapted to the COVID-19 Pandemic: A Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083940 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3940

Author(s):

Maximiliane Amelie Schlenz ◽

Alexander Schmidt ◽

Bernd Wöstmann ◽

Andreas May ◽

Hans-Peter Howaldt ◽

...

Keyword(s):

Patient Care ◽

Dental Care ◽

Health Care Professionals ◽

Dental Treatment ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Safety Measures ◽

Dental Clinics ◽

Positive Perspective ◽

Dental Assistants

Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health care professionals may be exposed to additional physical and mental stress. The aim of this study was to assess the perspectives of all persons involved in dental care (dentists, dental assistants, students, and patients) regarding the aspects of safety measures, anxiety about self-infection and infecting others, and other prospects in the period March to December 2020 using a questionnaire. Data collection was performed between 14 December 2020 and 23 January 2021. A total of 35 dentists (response rate of 79.5%), 23 dental assistants (65.7%), 84 students (80%), and 51 patients (21.8%) completed the survey. The patients did not notice any changes in the care received. Dentists and dental assistants reported a higher workload due to additional safety measures. The majority of dentists, students, and patients agreed that normal patient care was maintained. One-third of dental assistants would have preferred emergency treatment alone and expressed significantly higher anxiety about COVID-19 infection than all other groups (p < 0.05). In conclusion, all groups showed a predominantly positive perspective on dental care, and anxiety about self-infection and infecting others was especially low. However, additional measures are time-consuming and compound daily patient care. This concept, based on well-established infection control, might be a viable proposal for current and future pandemics.

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Stigma as a barrier to family planning use among married youth in Ethiopia

Journal of Biosocial Science ◽

10.1017/s0021932018000305 ◽

2018 ◽

Vol 51 (4) ◽

pp. 505-519

Author(s):

Aparna Jain ◽

Hussein Ismail ◽

Elizabeth Tobey ◽

Annabel Erulkar

Keyword(s):

Family Planning ◽

Supply And Demand ◽

Unmet Need ◽

Principal Component ◽

Principal Component Factor Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adolescent Groups ◽

Anticipated Stigma ◽

Youth Friendly Service

AbstractNearly 33 million female youths have an unmet need for voluntary family planning (FP), meaning they are sexually active and do not want to become pregnant. In Ethiopia, age at marriage remains low: 40% and 14% of young women aged 20–24 were married by the ages of 18 and 15, respectively. Despite increases in FP use by married 15- to 24-year-olds from 5% in 2000 to 37% in 2016, unmet need remains high at 19%. Supply-and-demand factors have been shown to limit FP use, yet little is known about how stigma influences FP use among youth. This study validates an anticipated stigma (expectation of discrimination from others) index and explores its effect on unmet need. A cross-sectional survey was implemented with 15- to 24-year-old female youth in Ethiopia in 2016. The analytic sample included married respondents with a demand (met and unmet need) for FP (n=371). A five-item anticipated stigma index (Cronbach’sα=0.66) was developed using principal component factor analysis. These items related to fear, worry and embarrassment when accessing FP. The findings showed that 30% agreed with at least one anticipated stigma question; 44% had an unmet need; 58% were married before age 18; and 100% could name an FP method and knew where to obtain FP. In multivariate regression models, youth who experienced anticipated stigma were significantly more likely to have an unmet need, and those who lived close to a youth-friendly service (YFS) site were significantly less likely to have an unmet need. Interventions should address anticipated stigma while focusing on social norms that restrict married youth from accessing FP; unmet need may be mitigated in the presence of a YFS; and the anticipated stigma index appears valid and reliable but should be tested in other countries and among different adolescent groups.

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Cross-national data on informal caregivers of older people with long-term care needs in the European population: time for a more coordinated and comparable approach

Journal of Biosocial Science ◽

10.1017/s0021932021000742 ◽

2022 ◽

pp. 1-5

Author(s):

Aviad Tur-Sinai ◽

Andrea Teti ◽

Alexander Rommel ◽

Valentina Hlebec ◽

Stecy Yghemonos ◽

...

Keyword(s):

Long Term Care ◽

Informal Caregivers ◽

European Population ◽

Policy Implications ◽

Care Needs ◽

Term Care ◽

Interview Survey ◽

European Health ◽

European Health Interview Survey

Abstract To promote long-term care policies for older adults, accurate mapping of the often invisible and insufficiently recognized role of their informal caregivers is needed. This paper measures the prevalence of informal caregivers in the European population, illustrates current difficulties in gathering unequivocal information on this topic and deals with the scientific and policy implications of the problem. Using the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS) and the Study on Health and Ageing in Europe (SHARE), the current difficulties in gathering unequivocal information on this topic are illustrated. In most countries, the share of informal caregivers varies, sometimes markedly, among the three surveys. As for the sex of caregivers, while confirming the well-known higher prevalence of caregivers among women than among men, large variations emerge across the three surveys in most countries in respect of the two sexes. The takeaway message of the paper is that it is urgent to promote international concerted action in gathering comprehensive informal caregiving information and/or exploring in greater depth the different intercultural understandings of informal care itself.

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Migration and integration: the case of health literacy (HLS-EU-PT) as a foundation to promote cultural sensitiveness

European Journal of Public Health ◽

10.1093/eurpub/ckz185.490 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

L Saboga-Nunes ◽

A Silva ◽

S Mendes ◽

B Almeida ◽

M R André ◽

...

Keyword(s):

Health Literacy ◽

Cultural Patterns ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Migration Patterns ◽

Proxy Variable ◽

Literacy Survey ◽

European Health ◽

New Challenges ◽

A Company

Abstract Background Portugal has experienced trough-out his recent history successive migration patterns. Lately, with instability in Syria and the Mediterranean routes of migration between Africa and Europe, new challenges have emerged. One of them is related to migrants’ health and their navigation of health care system. In order to better understand cultural patterns of migrants, this research aims to explore their health literacy (HL) in the context of the European Health Literacy Survey framework (HLS-EU). Methods A total of 748 participants from the different offices of a company in the financial sector (Portugal, main land and autonomous territories) participated in a cross sectional survey (CAWI). Age ranged from 25 to 65 years and HL was measured using the HLS-EU instrument validated to Portuguese (HLS-EU-PT). Each participant was allocated to one of the groups, either of satisfactory HL (when scores ≥30) or insufficient HL (when scores <30). In order to access the migrant condition, a proxy variable considered the participant’s parents origin: at least one of the parents was born in a foreign country. Results Out of the 748 participants, 4.1% (n = 31) were considered migrants. Of the migrant participants, 6.9% have inadequate, 51.7% problematic, 24.1% sufficient and 17.2% excellent HL (HLS-EU-PT). Migrants have lower levels of HL when compared with nationals in this sample (respectively 58.6% and 45.8% for insufficient HL) but this difference is not statistically significant. Conclusions Although results didn’t show an association between being migrant and lower levels of HL (when compared with nationals), it is nevertheless relevant to consider that more than 1 in every two migrants (58.6%) have insufficient HL levels. Special consideration should be given to this group to promote HL levels and further research is needed to better understand how HL and cultural sensitiveness may work for a better integration of migrants.

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Exploring the Influencing Factors of Health Literacy among Older Adults: A Cross-Sectional Survey

Medicina ◽

10.3390/medicina56070330 ◽

2020 ◽

Vol 56 (7) ◽

pp. 330

Author(s):

Hsiao-Ting Chiu ◽

Han-Wei Tsai ◽

Ken N. Kuo ◽

Angela Y.M. Leung ◽

Yao-Mao Chang ◽

...

Keyword(s):

Older Adults ◽

Health Literacy ◽

Influencing Factors ◽

Situational Factors ◽

Personal Factors ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Study Results ◽

Literacy Survey ◽

European Health

Background and Objectives: To investigate the health literacy (HL) among older adults in Taiwan, we referenced an existing integrated model of HL to confirm the influencing factors of HL in older adults. We propose this study to examine the personal, situational, and socioenvironmental factors influencing HL among older adults. Materials and Methods: A cross-sectional survey was conducted at a district hospital and affiliated community center in northern Taiwan from August 2016 to May 2017. This study used the Mandarin Chinese version of the European Health Literacy Survey Questionnaire (EU-Q47). We designed three models based on the three domains of HL. Model 1 assesses personal factors. Model 2 incorporates situational factors. Model 3 adds the socioenvironmental factor. Results: We recruited 161 participants aged over 65 years. Most adults in this study had limited overall HL. The final regression model revealed that age >85 years, unknown insurance status, and dominant spoken dialect of Hakka or Taiwanese were significantly associated with higher scores of HL. Conclusions: Our study results may help clinicians with early identification of older adults at high risk for poor HL and help health administrators establish geriatric policies and health education plans.

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Examining patient distress and unmet need for support across UK renal units with varying models of psychosocial care delivery: a cross-sectional survey study

BMJ Open ◽

10.1136/bmjopen-2020-036931 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036931

Author(s):

Maaike Seekles ◽

Paula Ormandy ◽

Daiga Kamerāde

Keyword(s):

Logistic Regression ◽

Service Provision ◽

Care Delivery ◽

Unmet Need ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Psychosocial Service ◽

Patient Reported ◽

Need For Support

ObjectiveTo examine in-centre haemodialysis patients’ emotional distress and need for support across UK renal units with varying models of psychosocial service provision.DesignThe study used a cross-sectional survey design. Logistic regression analysis was used to examine patient distress, as captured by the Distress Thermometer, and need for support, across different renal units.SettingSeven renal units across England, Wales and Scotland. The units were purposively selected so that varying workforce models of renal psychosocial services were represented.ParticipantsIn total, 752 patients were on dialysis in the participating centres on the days of data collection. All adult patients, who could understand English, and with capacity (as determined by the nurse in charge), were eligible to participate in the study. The questionnaire was completed by 509 patients, resulting in an overall response rate of 67.7%.Outcome measuresThe prevalence of distress and patient-reported need for support.ResultsThe results showed that 48.9% (95% CI 44.5 to 53.4) of respondents experienced distress. A significant association between distress and models of renal psychosocial service provision was found (χ2(6)=15.05, p=0.019). Multivariable logistic regression showed that patients in units with higher total psychosocial staffing ratios (OR 0.65 (95% CI 0.47 to 0.89); p=0.008) and specifically higher social work ratios (OR 0.49 (95% CI 0.33 to 0.74); p=0.001) were less likely to experience distress, even after controlling for demographic variables. In addition, a higher patient-reported unmet need for support was found in units where psychosocial staffing numbers are low or non-existent (χ2(6)=37.80, p<0.001).ConclusionsThe novel findings emphasise a need for increased incorporation of dedicated renal psychosocial staff into the renal care pathway. Importantly, these members of staff should be able to offer support for psychological as well as practical and social care-related issues.

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